Cardiology: tet spell: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Cardiology: tet spell

Sample item

A 2-year-old with tetralogy of Fallot becomes deeply cyanosed, irritable and tachypnoeic during crying. What is the first step in management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Knee-chest position with oxygen and calming the child

A hypercyanotic spell results from infundibular spasm and falling systemic resistance. The knee-chest position increases systemic vascular resistance and reduces the right-to-left shunt. Further measures are morphine, IV fluids, propranolol or phenylephrine, and bicarbonate for acidosis.

Option by option

  • A. Knee-chest position with oxygen and calming the child (correct)

    Correct. Knee-chest position raises systemic resistance.

  • B. Atropine

    Atropine does not treat the spell.

  • C. Digoxin

    Digoxin may worsen infundibular spasm.

  • D. Diuretics

    Diuretics reduce preload and worsen the spell.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is A, Knee-chest position with oxygen and calming the child. A hypercyanotic spell results from infundibular spasm and falling systemic resistance.

Why is "Atropine" not the answer?

Atropine does not treat the spell.

Why is "Digoxin" not the answer?

Digoxin may worsen infundibular spasm.

Why is "Diuretics" not the answer?

Diuretics reduce preload and worsen the spell.

What concept does this question test?

It tests Cardiology: tet spell in Pediatrics. The knee-chest position increases systemic vascular resistance and reduces the right-to-left shunt. Further measures are morphine, IV fluids, propranolol or phenylephrine, and bicarbonate for acidosis.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cardiology: tet spell?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.